Abstract

Abstract Purpose: Disparities in colorectal cancer (CRC) incidence and mortality persist in rural and underserved communities. As part of the NIH NCI’s long-term outreach and education plan to provide education and increase awareness about cancer risk reduction, the National Outreach Network Community Health Educator (NON-CHE) program was established to reach underserved areas through strong community partnerships. The NON-CHE project identified barriers to CRC screening and implemented the Screen 2 Save (S2S), a national initiative, to increase community knowledge, awareness, and engagement activities. In this study, we assessed the impact of this initiative in rural and underserved communities. Methods: Descriptive and comparative analyses were used to examine the role of the NON-CHE on CRC knowledge and CRC screening intent. Participants included the Massey Cancer Center (MCC) catchment area where 170 surveys were collected from rural and underserved communities. Data included demographics, participants’ current CRC knowledge, awareness, and future CRC health plans. A multivariate linear regression was fit to participants’ survey scores for CRC knowledge. All analyses were done in R 3.5.2. Results: NON-CHE engaged 441 participants in rural and underserved communities. At baseline, White participants had significantly higher CRC knowledge scores, correctly answering 1.94 (p=0.007) more questions on average. After the NON-CHE intervention, this difference was not statistically significant. The difference in participants’ CRC knowledge had an overall mean of 0.92, with a standard deviation of 2.56. Female participants exhibited significantly higher CRC knowledge after controlling for the effect of other demographic variables (p = 0.004). Female study participants also had significantly higher differences between their CRC knowledge scores, exhibiting an average gain in CRC knowledge of 1.08 questions higher than men (p = 0.043). Older participants also tended to demonstrate less improvement – specifically, a one-year increase in participant age corresponded to an adjusted average decrease in improvement of 0.02 questions. Greater than 95% of participants agreed that S2S sessions impacted their intent to get screened for CRC. Conclusions: The NON-CHE facilitated community connections and increased awareness of CRC risk reduction, screening, treatment, and research. Such programs should be considered as mechanisms that increase the knowledge, awareness, and engagement of rural and underserved communities. Equity of access to health information and the health care system can be achieved with precision population health strategies. The NON-CHE combined with S2S is a powerful way to engage rural and underserved communities and impact participants’ intent to “Get Screened”. Citation Format: Michael A. Preston, Debbie Cadet, Rachel Hunley, Reuben Retnam, Sarah Arezo, Vanessa B. Sheppard. How to improve health equity and colorectal cancer awareness: A Community Health Educator initiative [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-018.

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